A cure for Type 1 Diabetes - with Peripheral Blood Stem Cells

While researchers battle it out trying to prove the supremacy of various stem cell types (embryonic, mesenchymal etc.), it is worth remembering that so far, blood derived stem cells have been used for a great variety of cures (if you know of any human that has been actually cured with an embryonic stem cell, please let us know).

During my nocturnal, pre-bedtime web surfing (I suspect that I'm not the only one with this habit...), I came across a video describing the way blood stem cells* obtained from the same patient was used to provide a successful treatment for patients with recently diagnosed type 1 diabetes. This work isn't that new -I blogged about it back in 2007- but it is a very significant milestone in the history of stem cell transplantation.

Dr. Richard Burt's work is really quite demonstrative of how our blood and immune system plays a very significant role in whether our tissues and organs break down- and where stem cells obtained non-invasively from the same patient's own blood stream- have a clear role to play. I have yet to meet Dr. Burt in person but know him through his work and this video is the first I've seen of him providing a very clear insight into the trial that he is conducting. He highlights that 14 out of 15 patients were successful in treatment and this is an excellent base number to build on for the next clinical trial.

Dr. Burt published his work in the well renown and respected Journal of American Medical Assocation (JAMA), but instead of reading it I thought this video version sums it up really nicely for the non-medical and patient community.



If watching the video makes you more interested in reading the journal article, click on this link Autologous Nonmyeloablative Hematopoietic Stem Cell Transplantation in Newly Diagnosed Type 1 Diabetes Mellitus.


*StemLife offers individuals the opportunity to bank their babies' cord blood or stem cells from adult blood for therapeutic use.

Embryonic Stem Cells are Obsolete

This blog isn't about embryonic stem cells but I thought this bioethics opinion was interesting from the perspective of how adult stem cells are making progress whereas embryonic stem cells still have to defend themselves against criticism and that proving its application and safety will be an uphill battle.

Read:

http://www.investors.com/NewsAndAnalysis/Article.aspx?id=482427

Autologous-OWN-Stem Cell Infusion And Hyperbaric Oxygen Treatment Improve Islet Function In Diabetes

A study to determine if patients with type 2 diabetes can benefit from a combination of autologous (patient OWN self-donated) stem cell infusions (ASC) and hyperbaric (above the normal air pressure of ) oxygen treatment (HBO) before and after ASC has found "significant benefits" in terms of "improvements in glycemic control" along with "reduced insulin requirements."

The combination therapy could decrease type 2 diabetes morbidity and mortality, said the authors, who published their study results in a recent issue of Cell Transplantation (Vol. 17 No.12).

"Autologous stem cell therapies are an emerging set of therapies with promising results and low side effects profiles," said corresponding co-author Esteban Estrada, MD, of Stem Cell Argentina.

"In addition, hyperbaric oxygen therapy, used primarily in the treatment of carbon monoxide poisoning, air embolism suffered by divers, and as an enhancement to wound healing, has been shown to increase stem cell mobilization and the release of endothelial progenitor cells via a nitric oxide-dependent mechanism."

The clinical trial evaluated the safety of ASC-HBO combination treatment in 25 patients with type 2 diabetes.

According to the researchers, it is well known that with type 2 diabetes, there is an ongoing inflammation of the pancreas. Their hypothesis suggested that mobilizing stem cells would cause the growth of blood vessels (angiogenesis) and release factors that would result in the local differentiation of progenitor cells with a resulting anti-inflammatory effect. Diabetes, they added, has been shown to impair progenitor cell mobilization, a problem that local stem cell infusion could remedy.

Once more, the effect of the hyperbaric oxygen therapy, they hypothesized, would be to increase stem cell mobilization in such a way as "to target more than one crucial reparative step" to counteract the chronic injury that attack the endothelial progenitor cells and the islet cells.

"Overall, our results show that a close follow-up with intensive diabetic management alone could not be the only cause of the positive, progressive and consistent outcomes we obtained in this trial over one year of follow-up," said Dr. Estrada.

"A decade ago, research had explored stem cell transplantation and hyperbaric oxygen therapy as stand alone treatments. This study highlights the potential benefits of using an unusual combination therapy to treat diabetes" said Dr. Cesar V Borlongan, Associate Editor of Cell Transplantation and Professor at the University of South Florida College of Medicine.


References

Estrada, Esteban J.; Valacchi, Fabian; Nicora, Eduardo; Brieva, Sergio; Esteve, Claudio; Echevarria, Laura; Froud, Tatiana; Bernetti, Karina; Cayetano, Shari Messinger; Velazquez, Omaida; Alejandro, Rodolfo; Ricordi, Camillo. Combined Treatment of Intrapancreatic Autologous Bone Marrow Stem Cells and Hyperbaric Oxygen in Type 2 Diabetes Mellitus. Cell Transplantation 2008; 17 (12): 1295-1304.

STROKE and Your OWN STEM CELLS

"Every five minutes someone in the UK has a stroke and it is vital that we do all we can to help those affected by stroke."

Wise words from a team of wise scientists in the UK that pushed effective stem cell treatment for strokes a significant step forward as they revealed in their work is published in the Journal Biomaterials how they have replaced stroke-damaged brain tissue in rats.

The team of scientists is funded by the Biotechnology and Biological Sciences Research Council (BBSRC) and led by Dr Mike Modo of the Institute of Psychiatry, King's College London. The work, carried out at the Institute of Psychiatry and University of Nottingham, shows that by inserting tiny scaffolding with stem cells attached, it is possible to fill a hole left by stroke damage with brand new brain tissue within 7 days. Previous experiments where stem cells have been injected into the void left by stroke damage have had some success in improving outcomes in rats.

The problem is that in the damaged area there is no structural support for the stem cells and so they tend to migrate into the surrounding healthy tissues rather than filling up the hole left by the stroke.

Dr Modo said: "We would expect to see a much better improvement in the outcome after a stroke if we can fully replace the lost brain tissue, and that is what we have been able to do with our technique."

Using individual particles of a biodegradable polymer called PLGA that have been loaded with neural stem cells, the team of scientists have filled stroke cavities with stem cells on a ready-made support structure.

Dr Modo continued: "This works really well because the stem cell-loaded PLGA particles can be injected through a very fine needle and then adopt the precise shape of the cavity. In this process the cells fill the cavity and can make connections with other cells, which helps to establish the tissue. (picture)

"Over a few days we can see cells migrating along the scaffold particles and forming a primitive brain tissue that interacts with the host brain. Gradually the particles biodegrade leaving more gaps and conduits for tissue, fibres and blood vessels to move into."

The research published today uses an MRI scanner to pinpoint precisely the right place to inject the scaffold-cell structure. MRI is also used to monitor the development of the new brain tissue over time.

The next stage of the research will be to include a factor called VEGF with the particles. VEGF will encourage blood vessels to enter the new tissue.
Professor Douglas Kell, BBSRC Chief Executive said: "Stroke is a leading cause of disability in industrialised countries. It is reassuring to know that the technology for treating stroke by repairing brain damage is getting ever closer to translation into the clinic.

This crucial groundwork by Dr Modo and his colleagues will surely be a solid foundation of basic research for much better treatments in the future. Joe Korner, Director of Communications at The Stroke Association commented: "This research is another step towards using stem cell therapy in treating and reversing the brain damage caused by stroke. It is exciting because researchers have shown they are able to overcome some of the many challenges in translating the potential of using stem cells into reality."

The potential to reverse the disabling effects of stroke seems to have been proved. However the development of stem cell therapy for stroke survivors is still in the early stages and much more research will be needed before it can be tested in humans or used in practice.

Menstrual Stem Cell Banking by LifeCell India

Note to Indian Women: If you're having your period this week, you're probably an immediate target for LifeCell India.

One of the latest news articles to come out of Chennai this week is LifeCell India's announcement that they will be offering menstrual blood cell banking at their facility, adding to the cord blood business.

Personally, I think that most asian women would find this quite disgusting (and disturbing!) given that there are far more hygenic sources. What do you think?

The new service which commences on the 8th of March (Sunday) and apparently designated "Women's day" will be the launch, though I wonder how exactly one would launch a service like this.

LifeCell India signed on to license the technology from Cryo-cell which sent letters to all cord blood stem cell banks around the world (or at least they were courteous to send one my way) inviting any interested parties to license the technology which they were probably going to charge six to seven figures for.

Ironically, with the difficulties of obtaining parents to bank cord blood stem cells, LifeCell India seems unperturbed by the fact that menstrual cells are not even a proven source of stem cells and that culturally, there would be no objections.

"The limited availability of bone marrow led to the discovery of cord blood stem cells. Now it is proved that the success rate of menstrual blood stem cells is about 100 times higher than the 0.2 to 0.3% of stem cells derived from human bone marrow," said Mayur Abhaya, executive director, Lifecell International.

I'm a little skeptical about these statements, though to be fair I haven't read any scientific literature describing menstrual blood contents. But why would the body waste precious stem cells in menstrual blood? One can understand baby's cord blood, as that is blood that circulates through the placenta and the baby's developing blood system, but cells that are meant to be shed are probably already hormonally directed down a self-destruct pathway.

"These stem cells are unique because they multiply rapidly and can differentiate into many other types of cells such as neural, cardiac, bone, fat, cartilage etc," said Dr Ajit Kumar, chief scientific officer, LifeCell International. They can be used to treat everything from heart disease to diabetes to neurological disorders.

Assuming that stem cells can truly treat everything, they would still have to prove that menstrual stem cells can be manipulated to the same extent.

LifeCell will introduce special collection kits for women who wish to bank their stem cells. The kit has a silicon cup that can collect up to 30 ml of menstrual blood. "It is like a sanitary napkin or tampon, and can last up to eight hours," explained Abhaya.

Kind of messy isn't it?

If you'd like to know what questions to ask and what kind of assurances you're getting for your money, you might want to check out this posting that we reviewed a while ago.

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Singapore Advertises Cord Blood Stem Cell Banking (Part 1)

Last week in the Singapore Straits Times, there were two snippets about cord blood stem cell banking. The first one was a news piece on the Singapore public cord blood bank (entitled Cord Blood Bank has saved 21 lives**) which was campaigning for an increase in units (arguably an ad in itself). The other snippet was an ad by a local private Singapore Cord Blood Bank Cordlife. The ad appeared 2 days after the news article and I don't think its a coincidence to keep the conversation and interest in Singaporean's minds.

The first article from the Singapore Cord Blood Bank at a press conference reveals quite a lot about what its like to be an operator of a public bank:

How many cord blood stem cell units have been released and where have they gone?

"In the 3 years it has been open, the Singapore Cord Blood Bank has saved 21 lives - here and overseas... a 22nd donation was winging its way over to France"

"Of the 21 recipients, 12 were patients here while the other nine were ethnic Asians in Europe and Malaysia."

Comment: 21 cord blood units utilized in transplantation is very respectable for a small bank. Financially, at a purchase price of SGD 26,000 per unit in Singapore, the SCBB would have generated SGD 312,000 in revenue for the 12 Singaporean patients and another approximately SGD 320,000 from the 9 overseas patients (assumption is that these patients came through the NMDP network and paid the standard price). That would bring the SCBB's total revenue to SGD 632,000 or slightly more than this.


How many Singaporeans have donated cord blood and how many of those have been successfully banked?

"The repository has been able to bank about half of the 9,000 donations so far. Donations sometimes do not yield enough stem cells to be viable*."

Comment: The yield of 50% is very much in line with what I've heard from other public cord blood banks. However the article doesn't explain that units are discarded due to bacterial / viral contamination (let's not forget that vaginal flora and fauna can be quite substantial) and that the cord blood bank sets its own guidelines as to the volume and/ or cell count required at the beginning before they proceed to process the unit.

As a guide, at the time of receipt of the cord blood unit, most public cord blood banks insist on a minimum volume of 100 mls or total cell counts exceeding 1 billion. The rationale for this is that the cord blood unit needs to be at a level high enough to treat an adult (including caucasian weight & bigger sized asians), otherwise its not worth keeping (bearing in mind that this inventory can and most certainly will take years to clear). *Thus the term "viable" in the article refers to the unit's chances of being used.

Targets for the Singapore Cord Blood Bank?

"An earlier target of banking 10,000 samples by next year has been extended to 2013 said Mr. Sobak (SCBB's CEO and COO of SingHealth), since its been harder to get good-quality donations."

Comment: 10,000 units in the tank is an ambitious target but let's consider the following points:

1) The SCBB is based in the KK Women's and Children's Hospital, which alone delivers the vast majority of Singaporean babies has handled almost 40,000 babies at its peak, but more likely in the range of fifteen to twenty thousand now.

If the SCBB were able to collect all of the cord blood units from all the babies delivered there per year, without approaching any other hospitals (and discounting the 50%) the SCBB would have had about twenty thousand or so units by now. But, that would mean that they would have been working at a pace of 20 units per day seven days a week, all year round for 3 years. Hence the limitation of time, processing space and cost all plays a part in the operational capacity. [4 years more for 5000 units]

2) Cordlife, the first local Singaporean private cord blood bank started in 2001 only recently achieved 13,000 units in 2008 (announced in an ad) and claim only a 1% contamination rate, which means that they store almost every unit they receive. So repositories take a long time to build. [7 years for 13,000 units]

3) StemLife achieved 10,000 units in 2006, about 4 years after operational commencement (I assure you, not without toil).


Another target mentioned by the CEO was 30 transplants for the financial year 2009. I find this to be an interesting target, as I suspect it greatly depend on whether the requests just happen to match the units in the tank? Or perhaps it is now possible to analyze the recipient population and to try to identify the relevant donors to collect the cord blood from.

Anyway, getting back to the financial year for SCBB, I suppose the financial target would be in excess of SGD 1 million in revenue - if they manage to sell the inventory overseas. It is a business after all.


What are the likelihoods of use?

"At least six people are diagnosed daily in Singapore with different types of blood-related diseases said the bank's medical director William Hwang."

"Many of these patients will require a blood stem cell transplant to survive"

"With these samples and those fom banks worldwide, the odds of local patients finding a match is about 10-20%"


OK, quick back of the envelope calculation here. 6 people diagnosed daily in Singapore with a blood related disorder, ie 2000+ people. Let's say 50% will require a transplant at some stage, so let's bring the figure to about 1000 people needing a transplant.

And since only 10-20% will be able to find a match from all available units locally and internationally, ie 100-200 people will get their stem cell treatment... and the rest will have to wait.

The Suze Ormon Show on Cord Blood Stem Cell Banking

I was watching late night TV last year and happened to stumble across the Suze Ormon Show which I had never seen before. Her program entitled "Can I afford it?" discusses the value and worth of any particular item a person, couple or family would like to purchase in the USA.

In this episode, there was a lady who rang up to ask her opinion on cord blood stem cell banking and I thought it would be good to share with StemLife parents. She's quite keen on the subject but I don't think it was sponsored (no brands in sight). Anyway, if you missed it here it is and Suze Ormon is usually on CNBC late in the evening.

Autologous PBSC bone marrow transplantation for MS

Fantastic NEWS for MS patients. New hope in the horizon with OWN Peripheral Blood Stem Cells the way StemLife companies around SE Asia have been collecting and storing for the past 9 years. This novel phase US II/III study (click on the title to see the study) confirms what European scientists have been investigating in the past few years with dr Fassas in Northern Greece as one of them. So this study provides one more proof that in Patients with MS, their OWN Stem Cells can be their chance to live a normal life again!

If you wish a comprehensive list on MS, a presentation in pdf form is available after emailing to info@thaistemlife.co.th

Launch of NOVUSSANGUIS

Today marks the launch of a new international research consortium called Novussanguis for cord blood and adult stem cells. Its founding members, Professor Colin McGuckin and the Jerome LeJeune Foundation plan to bring together key researchers to discuss and collaborate on the development of stem cells for clinical application.


The launch is held in Paris today and I'll provide some insights about it later on. Here's a snapshot of the launch program.

Bioengineering like the movies: Stem Cell Capturing Gadget

I'd hate to sound as if I was brought up on an entertainment diet of Hollywood movies, but back in the 1970's to 80's there was a real revolution in cinematic production and audience interest that led to a cult following of the science fiction genre.

Film directors often take what's probable in science and stretch them to the limits of our imagination, engaging us to just reflect on not only how far we've come but also how much further we can aspire. This next entry is a tribute to the 1987 movie "Inner Space"*.




In a recent announcement, MIT's bioengineers have designed an implantable device that is capable of capturing pure samples of stem cells from the circulating blood. The device is described as "a length of plastic tubing coated with proteins" which has been experimentally implanted into the bloodstream of rats.

The more accurate medical description of this plastic tubing is known as a "shunt" and the method of implantation would most likely involve the severance and reconnection of a small but high through-flow blood vessel. The proteins -known as selectins- attract and trap specific cells with the right signals on the surface (imagine a sticky mat). The cell capture devices are developed by chemical engineers led by Associate Professor Michael King from the Biomedical Engineering department at the University of Rochester. The technical details will be described in the March edition of the British Journal of Hematology.

(personal note: Mr. B.C. this is for you.)


WHY IS THIS DEVICE IMPORTANT?


The medical impact of this device could weigh in for cancer patients who may need to use autologous (one's own) stem cells for their treatment. These cancer patients are treated with chemotherapy to reduce and eliminate as many of the malignant circulating cancer cells as possible from the bloodstream and bone marrow. The treating doctor will collect the patient's own stem cells during this period of remission when the cancer load is at its lowest.

The patient's own stem cells are stimulated using GCSF (read about it here) and the stem cells are harvested and stored in anticipation of the possibility that the cancer cells will multiply again, requiring another round of chemotherapy which may damage the existing healthy marrow further. The collected stem cells will be infused back to the patient to ensure that the patient has sufficient stem cells to repopulate and replenish the marrow, thereby restoring normal cell levels to the bloodstream.

To address the concern that perhaps cancer cells from the patient might also be collected in the same fraction as the healthy stem cells (impossible to distinguish during harvesting) this device could lend a hand to filter out the cancer cells inside or out of the patient's body, i.e. the cancer cells would travel around the bloodstream until they reach the shunt, where they would then be immobilized.

Note though, that the inventors have conceded that this device will not be able to collect enough stem cells for a transplant, therefore the customary stem cell collection procedures will still need to be performed.


SOME INTERESTING STATISTICS


According the A/Prof. King, the shunt placed in an non-GCSF induced rat in a 2 hour period enabled the capture of 3-4 times the number of usual stem cells obtained in normal circulating bloodstream (approx 1%). Hence the device is thought to attract and specifically retain a significantly higher number of stem cells.

This stem cell number could be significantly higher in patients who have been mobilized.


WHAT ELSE CAN IT DO?


Well, it is a concept device which will be as good as its selectin coating. A/Prof. King has already forecasted the use of the device in trapping specific cancer cells in the body to prevent metastatic spread and layering in proteins which could help steer cell development processes by differentiating them while passing through the shunt. (analogy: think sticky mats for dust, sticky mats for cockroaches, sticky mats for cat fur...all requiring different levels of stickiness for its target)



WHEN CAN I BUY IT?


The entrepreneurial A/Prof. King has already started a company by the name of CellTraffix and the anti-metastasis implants are set for animal trials later this year in collaboration with bioengineers Professor Jeffrey Karp and Robert Langer at Harvard and MIT who will develop stable selectin coatings that will last over months than days. Meanwhile, the CEO of CellTraffix, Tom Fitzgerald has already announced that the company's first product for researchers to capture stem cells or cancer cells for lab experimentation will be marketed by early 2009, with clinical testing of the anti-cancer coatings in 2010.


Read how a chance encounter between a bioengineer and a haematology clinician gave rise to this work and watch the cells being captured here (note that you will need a high speed broadband connection as the video files are rather large).


*Why does this remind me of the movie Inner Space I hear you ask... well the term cell capturing device often conjurs up the image of a little machine (like the exploration submersible the protaganist uses) to grab and hold onto cells in circulation :)

Brain Stem Cells killed by Space Radiation

A lot of the concepts surrounding that of anti-aging first involves protecting and conserving what the body has left to the best of your ability and secondly attempting to regenerate and increase the number of functionally productive living cells in the desired tissues and organs.

In a previous blog entry, I described a face cream by Dior (Capture) which promises to protect and nourish the remaining stem cells one has left in wrinkled skin. If you are a frequent long-haul air traveller (Richard Quest please take note), you might wish to give a small thought to this rather esoteric but possibly significant research study -which was conducted by the researchers at Cold Spring Harbor, Brookhaven National Laboratory, the Kennedy Space Center and the University of Florida- published the the Journal of Experimental Neurology.

For those of us who spend enough time in the airplane and feel that we could have reached Mars and back, we might wish to consider plausible types of protection for the stem cells in our brain responsible for learning and memory.

In the preparative research for the proposed next NASA project to put a man on Mars, scientists conducted an experiment with mice where a single dose of radiation was administered considered to be equivalent to the amount an astronaut might be exposed to during a 3 year space voyage to Mars and back. What they found was that the radiation particularly affected the stem cells in the region of the hippocampus.


"We are going to have to rethink our understanding of stem cell susceptibility to radiation, including cosmic radiation encountered during space travel, as well as radiation doses that accompany different medical procedures," said Professor Dennis Steindler of the University of Florida, co-investigator of the study.


WHAT IS COSMIC RADIATION AND IS IT SOMETHING TO WORRY ABOUT?

Well, this really depends on how much long haul, high altitude flying you get to do as part of your job. Air crew and presumably flight military will be subjected to the highest amounts of exposure. Background cosmic radiation at ground level have been established at 2-3 mSv (microSievert) which is considered natural exposure. In the plane, higher altitudes reduces the protective layers in the atmosphere which shield most of the cosmic radiation and thus cosmic radiation exposure is increased. If you'd like to have an indication of cosmic radiation levels during flight, have a look at this table on the WHO site. (Note: if you're flying the A380 long distance at 43,000 feet, you'll need to double the figures up by 2)

As a result of this, aircrew are now monitored and their time tables adjusted accordingly to ensure that they do not exceed the recommended dose. The WHO and the UK Department for Transport also does not recommend pregnant air stewardesses to work on flights due to the exposure to the unborn child.

Or we can live near the equator where cosmic radiation is reduced by half.



HOW CAN WE PROTECT OUR STEM CELLS FROM COSMIC RADIATION?

Come to think of it, maybe those Imperial Stormtroopers might have been wearing reasonable looking outfits for the fight and flights through space to protect their cells. Ridiculous as it may have been (note that Luke and Leia never wore any type of helmet or protective outfit) astronauts going out on a space walk have to put up with much more cumbersome outfits due to the numerous protective layers.

A CHALLENGE FOR SPACE BIOENGINEERS AND PHYSICISTS

NASA engineering scientists are working on new materials and polymers which confer more protection and estimate that a new spacesuit which will be worn by the super-fit astronauts on Mars will be as light as 21 Kg and comprise of 12 different layers.

Better shielding on spacecrafts are also on the way (using water as an absorbent material) and hopefully, some of this technology will also filter down for use in commercial flights so that we can reduce our cancer risk (bad enough already) and retain as many hippocampal stem cells as possible.

As for the rest of us who are already losing our memory and learning capabilities due to cosmic radiation, we'll have to see about how to potentially replace and regenerate new stem cells along the way without resorting to NASA designed storm trooper outfits when we board the A380 from Singapore to London or New York.

Program on Stem Cell Therapy for Joint and Bone Diseases

It's now 8:34 pm and I'm wishing that I could catch the program on Channel News Asia right now, except that I can't get it here in KL. The program is named the "Medical Touch" and features some interesting degenerative joint conditions and how stem cell therapy can help. If you're able to catch it, I'd appreciate your feedback on the program.


The Medical Touch
Episode 11
The Medical Touch drills down on degenerative bone diseases to uncover the bare bones about joint pains, myths shrouding an emerging silent killer and the promise of stem cell therapy. Osteoporosis starts decades before onset. So do the opportunities to prevent and reverse it. Bone up on how to keep yours strong and wise up on why you should not take your skeleton for granted.

"I want to look like Sharon Stone..."

... I suppose this must be what all the American 35+ year olds must be thinking as they rush out to buy Christian Dior's latest product on Macy's shelves on the weekend (Sharon Stone is the advertising model for "Capture" chosen by LVMH).


COSMETICS MOVE ASIDE

The product -which sounds like a piece of sexy photographic equipment or imaging software- is called Capture 60/80 XP and claims to have "lassoed the power of adult stem cells to help repair wrinkles". (For the interested Asian clients, Christian Dior plans to launch it internationally at the start of 2008)

The product was researched and developed by researchers at the Dior innovation center and the researchers at LVMH in collaboration with Professor of dermatology Carlo Pincelli, who heads the research unit at the laboratory of cutaneous biology in the University of Modena and Reggio Emilia in Italy. It contains a collection of treatment creams and serums for the face and eyes which target women in the 35+ age group who are trying to escape the clutches of skin aging by protecting their adult stem cells in the skin, making them more active and thus reduce the formation or deepening of wrinkles.

The article states that the company's patented "Stemsome" technology and TP-Vityl ingredient is included in the Capture cream's formula and works on a time release system to protect basal cells and the skin's bionectin scaffold which keeps the collagen in place.


HOW MUCH FOR OVER THE COUNTER REGENERATIVE COSMETICS?

The Capture R 60/80 XP collection includes 30- and 50-ml. bottles of serum, which retail for 80.90 euros and 106 euros, or $119.40 and $156.45 at current exchange, respectively. There are also 30- and 50-ml. jars of cream in a light texture and similarly sized jars of cream in a rich texture for 57.80 euros and 86.30 euros, or $85.30 and $127.40, respectively. The 15-ml. eye cream sells for 53 euros, or $78.23. Prices are for France.

In comparison, StemLife stores cord blood stem cells for the equivalent of 5 jars of cream.

While Dior executives would not discuss numbers, industry sources estimated that Capture R 60/80 XP will generate $37 million in wholesale business during its first 12 months worldwide.

SUPPORT FOR STEM CELL INDUSTRY

Interestingly, the article states that some of the proceeds from the sale of Capture will go to Standford University's adult stem cell research funds, which might be a contribution to the Institute of Stem Cell Biology and Regenerative Medicine


It's been known for years that by merely applying cosmetics, women can make themselves more attractive and appear youthful, but can we really nourish our stem cells and prevent them from dying using a cream kept in our cosmetic case? I'll have to ask someone who's going to use the creams. Well, I guess if there's any bit of skin on our body that is most exposed to UV rays and all other environmental insults, it would be our faces. Maybe I'll buy it for a friend as a present and see if those wrinkles do indeed disappear...

The Best Gamble in Las Vegas: Bet on Your Stem Cells

Neostem, a company formerly known as Phase3Med, based in New York (USA) which collects and stores adult stem cells has been around for quite a while. One of their directors was here in Malaysia 3 years ago at one of the locally organized biotech symposiums and expressed a certain interest and admiration for the work that we have accomplished thus far.


LAS VEGAS MEDICINE

After a short hiatus about two years ago where there was a change in management and ownership, the company has started to make regular press announcements about their expansion of collection services in the US in collaboration with aesthetic doctors. Neostem held a press conference last Friday (Oct 23rd) which was sponsored by the Nevada Development Authority and the University of Nevada and a few local companies. Neostem used the opportunity to present to the Nevada Biotechnology and Bioscience Consortium to educate the region's medical and scientific community.


The collection site is apparently sited near the Nevada Cancer Institute and the Nevada Neurosciences Institute. Its CEO Robin Smith said that its expansion in Las Vegas was quite obvious given the large size of the city's population, its tourist attraction status and that tourists also visit for the health and spa-oriented services offered by the hospitality industry. Neostem's target clients for adult stem cell banking include anyone concerned with their long term health or well-being. They are also targeting people concerned about possible exposure to radiation.



MONEY MATTERS

Neostem listed on the American stock exchange on the same day as the Nevada announcement, is unfortunately already trading down and has a market capitalization of 14 million USD. The rapid expansion over the last three years has been loss-making for Neostem (approx. twenty million US dollars) according to its last audit in March. Most of it was operating expenses (expensive infrastructure and qualified personnel requirements).


However, medical director of the Las Vegas facility, Dr. Ivan Goldsmith expressed his enthusiasm to target both residents and tourists and convince them that storing their own stem cells for their future might be a better bet than the gaming tables.


He said: "The odds are far greater that you will eventually be a winner having your stem cells banked"



StemLife offers adult stem cell collection and banking in Malaysia and Thailand. If you're in the region and interested in this service, give us a call. :)

Hip Replacements- Made Real by Surgery and Stem Cells

When my friend's mum fell and broke her femur about 3 years ago, she had to have almost complete bed rest for six months and physiotherapy and rehabilitation for close to three months after that. With a metal screw pin in her thigh bone and a cast around her leg, it was probably the most uncomfortable and frustrating experience for someone who was living a very active lifestyle (tai chi, walking in parks, overseas travel etc.) prior the incident. She has since recovered from the injury but mentions feeling occasional discomfort and tightness in her thigh.

Most people live their early and active life not expecting any bone surgery (unless it is cosmetic) and most fractures tend to happen in osteoporosing elders over sixty. However, hip fractures are far worse than femur fractures the incidence of hip fractues increase with age, doubling for each decade after fifty. Most people who fracture their hips in old age have a poor quality of life and often get depressed and there are estimates that one in four people who fracture their hips completely heal while 20% of those who fracture their hips do not survive the year of their injury.

Given these considerations, it is therefore not surprising that doctors and bio-engineers are often looking at ways to make prostheses more natural and better accepted by the body. In the reported work that is currently being done at University College London (UCL), the doctors are keen on ensuring that people who require a second hip replacement (about 25% undergo a second surgery) will have a better outcome rather than suffer a crumbling joint with a high probability of trauma (apart from a nasty scar) and protracted recovery period involved.


Professor Gordon Blunn's team at UCL's Institute of Orthopaedics collaborates with Dr. John Skinner's group from the Royal National Orthopaedic Hospital in Stanmore, are conducting a trial with a GBP 130,000 (approx. RM 897, 150) grant from the UK Stem Cell Foundation and the Medical Research Council for a preliminary trial -to boost patient's bone growth by 75%- which will lead to a larger trial of 80 patients next year.

The current method of surgery requires bone chips to be packed into damaged hip joints to rebuild, followed by the insertion of the artificial replacement hip. What the research team will do is to improve the quality of the implants by infusing the bone chips with the patient's own stem cells, which they believe might act as a better cement and cause less inflammation.

The cells would be obtained from each individual patient's bone marrow which is extracted from the patient's hip bone under anaesthesia, isolated and grown in the laboratory and used to seed the bone chips.

The cell culture is estimated to cost approximately GBP 2,000 (approx. RM 14,000) and this probably excludes the cost of the surgery and any ancillary medical care.

The Chief Executive of the Medical Research Council, Sir Leszek Borysiewicz summarized this work most clearly when he said:

"The idea is to use autologous stem cells [taken from the patient themselves] to accelerate healing and outcome."



QUESTIONS AND THOUGHTS

I thought that there were a few interesting points to take from the concept and the trial.


APPLICATION IN OTHER BONES

Firstly, that marrow stem cells were being infused into the interior of artificial bone as seeding for normal bone structures to form.
-This is not the first time that stem cells have been used to seed bone growth and to kickstart the healing process. It would be interesting to see this method applied in other bones too.


AGE IS NOT AN ISSUE

Secondly, that the autologous stem cells harvested from the patient (usually 60-80 years of age) would still be clearly functional for this purpose, demonstrating that stem cells obtained from an older individual is still useful.


ENOUGH FROM THE SOURCE?

Thirdly and curiously, I wondered where the stem cells would be harvested from in these patients. One has to bear in mind that marrow stem cells are usually collected by puncturing the hip bone. Hence, if these patients are already having their second hip replacement, there can't be much left after all the inflammation and debris to harvest. This might provide the reason why stem cell isolation and growth in the lab becomes an important factor.

The number of stem cells infused needs to be optimal in order for the healing to accelerate and outpace the degenerating tissue, by signalling the required repair factors. I would be most interested to know what that optimal number might be in these cases.



*An renown South African orthopaedic surgeon that I spoke to recently told me that at a recent medical convention, he asked the audience (all doctors) who would undergo and prefer a prosthesis vis-a-vis a natural joint. The answer? Nobody raised their hands for a prosthesis.

Verdict: 100% of doctors themselves would opt for a natural method of joint salvage than have a prosthesis inserted.


If you'd like to watch a hip replacement procedure, here's one I found which gives you an idea of what happens but is censored so that there is none of the gore...

First Ever Beijing Stem Cell Donor for Taiwanese Recipient

Despite any political maneuvering between China and Taiwan, it is articles like these (1, 2) that bring our minds back to the basics- which is that geopolitics aside, our genetic heritage links us and binds us eventually to a common fate.

Additionally, stem cell resources will always reside with the size and diversity of the population, hence China with more than 1.3 billion is a stem cell treasure trove for chinese people all over the world if we are able to thoroughly profile and screen the stem cells.


The article which I noted a while ago (sorry, it's a late comment, but I thought it worthwhile) reports the first time that stem cells were matched from a patients in Taiwan to donors in Beijing*. The two profiled donors were Ms. Hang from Jiangsu province and Ms. Xiaoyan from Hunan province. (click here if you'd like to know where the provinces are in relation to Beijing)

They were brought to Beijing and their stem cells were mobilized from their bone marrow to the bloodstream (you can read more on mobilization and collection here) and their stem cells collected via apheresis. Their stem cells were subsequently transported to Taiwan for the transplantation.

The second article provides a little more detail on the donors and their perceptions of stem cell harvesting and donation.

Ms. Hang who is a youthful 36 year-old is a registered blood donor who has donated blood several times in her life. Apparently, a marrow bank was established in her home province in 2003 but few people registered as donors. Ms. Hang signed up as a donor in the registry not only because her employer, Amway urged all employees to do so, but also because she saw it as "an opportunity to help others... why not do it?"

Amway's staff registration yielded 1,500 new potential donors and they report that 4 of them have already been called on as donors.

Ms. Hang's father is a doctor and said that the process of mobilizing and collecting stem cells was harmless and supported her decision to donate. The recipient was a 16 year-old girl and I hope that they collected as many stem cells as they could and that the patient has recovered.



*Taiwan has exported stem cells obtained from donor's cord blood, bone marrow and peripheral blood to patients all over the world. Cord blood stem cells obtained from a private company that facilitates the storage facility for databasing and sale, Stemcyte incur a charge of between RM 100,000 to RM 150,000 per unit (they have released in excess of 250 cord blood stem cell units). Some patients have also withdrawn 2 cord blood stem cell units to use in a double transplant when one unit is insufficient.

Malaysian patients have accessed this facility many times and have been able to find successful matches which has allowed life-changing stem cell transplantation to proceed.

Credit also goes to the Tzu Chi Taiwan Marrow Donor Registry, the third largest of its kind in the world, which has made over a hundred matches for mainland patients and patients in South East Asia.

Going Deaf? Hello Stem Cells?

"GRANDDAD, DO YOU WANT SOME TEA?"

The reason why I enjoy reading about stem cells is because everytime an article is published on a novel application, I can think of someone who might benefit from it. In this case, its my grandfather who is presently a healthy 96 year-old (or young depending on his mood).

He is still energetic and full of enthusiasm but one of the first senses to deteriorate was his sense of hearing. He started off with just one hearing aid about ten years ago but now has one in each ear. It has become quite difficult to communicate with him now unless you can get his attention visually or by gently nudging him first (and if he turns up his hearing aid, we get the do-doo-do sounds due to the radio requencies when a nearby mobile phone rings).


Hearing Loss

Hearing loss has many causes, including genetics, aging, and infection, and may be complete or partial. Such loss may involve damage to inner ear cells called cochlear fibrocytes, which are fundamental to inner ear function.

Blind as a Bat, Deaf as a ......



Stem Cells Restore Hearing

Anyway, this article tells us of some exciting research published in the American Journal of Pathology (well, exciting to me anyway) conducted in the National Tokyo Medical Center (Japan*) by Dr. Tatsuo Matsunaga. He came up with the idea of finding out if bone marrow derived stem cells could help to restore damaged cochlear fibrocytes and thus speed up the recovery of hearing.

Dr. Matsunaga and team came up with the devastating idea of killing off these cochlear fibrocytes with a drug in mice, thus inducing an acute hearing loss. Partial recovery due to innate stem cells may occur over many weeks but these poor mice almost never regain their high-frequency hearing. Dr. Matsunaga then explored if direct administration of stem cells into the inner ear of these mice might restore the lost cell population and consequently, hearing.

The results were very interesting.

Stem cells injected into the inner ear survived in half of the injured rats, where they migrated away from the site of injection toward the injured region within the inner ear. These stem cells divided in the new environment and expressed several proteins necessary for hearing, suggesting tissue-specific differentiation. Further, transplanted cells that migrated to the damaged area of the inner ear displayed shape similar to that of cochlear fibrocytes.

Importantly, transplanted rats exhibited faster recovery from hearing loss, particularly in the high frequency range, which is difficult to restore by natural regeneration. Stem cell migration into the damaged area of the inner ear improved hearing of high frequency sound (40 kHz) by 23% compared to natural recovery in untreated animals.

So it appears that the stem cells are able to "home in" on damaged areas of the inner ear and initiate regeneration of the lost cells, and that the transplanted cells were able to adapt morphologically and functionally to their new environment.

My questions are how the stem cells are injected** into the inner ear (under X-ray guidance?), how many stem cells we'll need and whether it might work on a 96 year-old. I think this work is very exciting and I'd really like to tell my grandfather about it, but I'll wait to tell him in person, not over the phone :).



*The work was supported by grants, one of which was from the Japan Foundation of Aging and Health. It is interesting to note this as Japan as one of the most serious aging populations in the world today.

**Have a look at this interesting cochlear implant (developed by Seoul National University) which gets inserted all the way into the cochlear and connected to a speech processor. Read this page if you want an idea of how cochlear implants are surgically implanted and its risks.




On another note, I found this very interesting language company in Luxembourg. The emphasis of its founder, Dr. Alfred Tomatis, is that you have to be able to hear the language before you can speak it with the right tones. The teaching method involves the assessment of your auditory abilities before you commence the language course. Notice how English speakers are on the higher frequency whilst other european languages tend toward the lower frequencies.

Bristol Cardiac Team Uses Stem Cells for Heart

Articles from or about Bristol always brings with them a sense of nostalgia for me and its been a while since the last opportunity to visit (StemLife keeps me in Asia, mostly).

Anyway, back to the stem cell news. I was very pleased to see that the Bristol cardiac team based at the Bristol Royal Infirmary and at the University will in August start a stem cell program which involves the injection of autologous (patient's own) bone marrow stem cells into the affected heart during routine coronary bypass surgery. The surgeons, led by Dr. Raimondo Ascione, believe that stem cells can assist in the healing process post surgery, reducing scarring and thereby improving the heart's pumping action. Follow-up time of the patients is stated to be six months, which I think is a perfectly reasonable length of time (based on our experience here).

The work is funded by the British Heart Foundation and amounts to GBP 210,000 (approximately 1,455,070 RM).


The article describes why the surgical team acknowledges the usefulness of stem cells:

In a heart attack, blocked blood vessels starve the heart's muscle of oxygen and cells in that part of the heart die, leaving scarring.

The scarred heart is then less able to pump blood around the body and can lead to heart failure.

While the blood supply to the heart can be improved with coronary bypass surgery or angioplasty (mechanical stretching of the heart blood vessels), these techniques do not restore the viability and function of the area already damaged.

And scarring can cause further complications - a fifth of patients develop a dangerous thinning of the walls of the heart within six months of bypass surgery.

The patients who will be selected are those who suffered a heart attack between 10 days to three months ago, and half of them will receive the stem cells, while the other half will receive a dummy injection.


Are there any ethical issues?

Dr. Ascione says that using the patient's own stem cells will not only avoid the risk of rejection and infection, but also get round any ethical issues sometimes associated with embryonic cells or foetal tissue (which is hotly debated). It was also great that Professor Jeremy Pearson, Associate Medical Director of the British Heart Foundation, is also looking forward to stem cells being used routinely in the repair of damaged hearts.


At StemLife, we also offer adult-derived stem cell therapies for patients with ischemic heart disease. Not all patients are eligible for the program however, so please check with us to see if you're a suitable candidate.

Surgeons Using Stem Cells for Bone Fractures

I was intrigued when I saw this article, not so much by the actual announcement of the stem cell work performed, but rather exactly where the location of the hospital was and I was surprised that hospitals outside the major cities of England were also conducting stem cell therapeutic trials.

Oswestry, I found out is a small town in the county of Shropshire, off Shrewsbury on route to the Cambrian mountains near Wales. The Robert Jones and Agnes Hunt Orthopaedic Hospital in Oswestry does look like an excellent hospital and has a website which is very detailed. It is clear from the description of the hospital's history that pioneering new techniques and investing in research is a priority, so stem cell clinical application is certainly on their checklist.

The consultant surgeons there have been conducting clinical trials using stem cells obtained from patient's own bone marrow (autologous) to heal bone fractures which could not be successfully healed with conventional techniques using metal pins and plates. According to the report, the research trial plans to take in forty patients. Fifteen patients have since undergone the treatment and 8 out of the first 10 patients followed up are successfully healed (able to drive and return to work).

The procedure:
Surgeons harvest the stem cells from the patient's pelvic bone and multiply the stem cells for a period of 3 weeks.

Consultant surgeon Professor James Richardson said: "Things have worked out quite well. A few patients have needed other procedures, refixation for instance, but the important thing is they're healing."
Surgeons collect the stem cells in a sample of bone marrow, usually from the patient's pelvis. They are purified and then multiplied in a sterile laboratory. 3 weeks later, the surgeons have to re-expose the fracture and place the stem cells at the site. After a few months, the bone appears to regain the strength of its original structure. One of the patients, Sarah Humphreys was one of the first patients to be treated with stem cells and is now able to walk unaided.

She said: "I'm absolutely fine, the leg doesn't give me any problems at all apart from a bit of residual pain if I've been for a long walk, or been a bit more active than I would have been, but not to the extremes it was. I'm basically doing everything I was prior to the accident."

The surgeons aim to treat 40 patients in the clinical trial and due to the autologous nature of the cells, there are no chances of rejection. They are unsure as to how the stem cells transplants work (nature does in deed work in mysterious ways) but speculate that the cells may turn into bone and seal the gap, or play a role in the secretion of chemicals that kick-start the healing process.

The article states: These are experimental treatments for now. But surgeons say the results so far are so promising that stem cells are likely to be widely used on the NHS in a matter of years.


Editor's Note:
I am particularly enthused by these results as StemLife has also been obtaining positive results from patients who have had stem cells in combination with their orthopaedic procedure. We have also been working with a niche and focussed orthopaedic hospital- the Kuala Lumpur Sports Medicine Center. If you have a cartilage injury that you'd like to discuss and explore stem cells may help in its healing, please give us a call.

Expert Hematologists Say Stem Cell Harvesting is SAFE

If you've been following this blog for a while, this probably isn't news to you, but I thought that this article only lends further credence to those patients concerned about whether stem cells are safe to collect.

Baby umbilical cord blood stem cells certainly are safe to collect, and very apparently so are adult stem cells. The article is so clear in its message that I thought it would be good to excerpt it here for you to read just in case they take it off line.



Experts At Hematologists' Congress In Vienna Say The Procedure For Donating Stem Cells Is Safe EHA Congress 2007
14 Jun 2007

Donating stem cells is almost free of risk for donors and is often the only chance of survival for many patients with certain severe blood or bone marrow diseases. This was the conclusion arrived at in an observation study conducted by the Medical University of Hanover and just presented at the Congress of the European Hematology Association in Vienna.

Stem cell donors can save lives. The only way to fully cure most types of blood cancer (leukemia) is through the transplantation of what are called hematopoetic stem cells, i.e. by transferring healthy blood-building cells from an appropriate donor. Physicians cannot call on cell donors in good conscience unless this procedure is free of danger. There have been isolated cases of donors reported in the past who themselves came down with leukemia several years after making their life-saving gift. Researchers undertook a number of different studies to determine if there was any connection here.

The Congress of the European Hematology Association (EHA), the leading association of experts on blood and bone-marrow diseases in Europe, is currently being held in Vienna. One of the speakers, Dr. Michael Stadler, senior physician in the Department of Hematology, Hemostaseology and Oncology at the Medical University of Hanover (D), presented the results of a recent study on this subject: "Since March 1994, we have examined nearly 600 donors of bone marrow or peripheral stem cells and determined that the donation of stem cells is a very safe procedure. We have not detected a single case of leukemia to date among our donors and unpleasant side effects occurred for a total of only one percent of these individuals."

The study involved 596 donors aged one to 71 (60% males, 40% females). Both common methods of hematopoetic stem cell transplantation were represented, namely classic bone-marrow transplantation and the modern method of peripheral blood stem cell transplantation.
"Bone marrow can only be extracted under general anesthesia and requires a one to two-day hospital stay," explained Dr. Stadler. "During this procedure, a half to one liter of a mixture of blood and bone marrow is suctioned from around the donor's iliac crest, not from the spinal cord, as is often falsely reported. This mixture is filtered and then transfused into the recipient by way of intravenous infusion. The intervention itself takes about one hour. The bone-marrow cells that are removed are replenished in the donor within about two weeks by subsequent cell growth."

Peripheral blood stem cell transplantation is an even simpler and more comfortable procedure for donors. The reason for the designation is that the stem cells are taken not from bone marrow but from the blood stream at the periphery of the body, e.g. from a vein in the arm. This procedure does require biochemical preparation, however. Dr. Stadler: "For a period of five days beforehand, the donor receives a substance called G-CSF, which stands for Granulocyte-Colony Stimulating Factor. G-CSF is a hormone the body produces itself and is released in the case of inflammations to stimulate the reproduction of white blood corpuscles. If administered as a drug in high doses, it accelerates the overall formation of blood and causes blood stem cells that are not yet fully matured to be detached from their environment in bone marrow, for lack of space you might say. These stem cells make their way to the peripheral blood stream where they can be fished out for the patient using a special separation method called stem cell aphaeresis."

G-CSF stimulation in particular was long suspected of being a possible trigger for leukemia in donors over the long term. In their long-time study, however, Dr. Stadler and his colleagues did not observe a single case of leukemia or a single case of death over a period of more than 12 years.


The risk of anything happening to you in harvesting your own stem cells is really minimal, so please don't be afraid to donate or bank your stem cells for yourself and your family members.